Ascites: He aratohu māmā ki ngā take, ngā tohu, me te maimoatanga

Kua pupuhi tō puku, kua piri ō kākahu, ā, kua kī tonu i te wai? He mea noa tēnei i ētahi wā, engari i ētahi wā he tohu pea tēnei mō tētahi raruraru hauora nui. I tēnei rā ka kōrero tātou mō tētahi o aua mate, ko te "Ascites." Koinei te wā e kohia ai te wai, te wai rānei, ki te wāhi takoto kau i te taha o ngā whekau o roto i tō tātou puku.

He aha tonu te ascites?

I te whakarapopototanga, ko te ascites he kohikohinga wai rerekē i roto i te āputa i waenganui i te kōhao puku (peritoneum) me ngā whekau puku. Kāore tēnei e puta i te nuinga o te wā i roto i te tangata hauora. Ahakoa he iti noa te wai i roto i te puku, ehara i te mea he ascites. Ka tautuhia e ngā tākuta tēnei āhuatanga hei ascites ina he 25 miririta (0.8 auneke) te iti rawa o te wai.

Ko tēnei āhuatanga te mea tino kitea i roto i te hunga e mate kino ana ki te ate. Tata ki te 80% o te hunga e mate ana i te ascites he cirrhosis o te ate. Hei tāpiri, ka taea hoki te puta o te ascites e ētahi atu āhuatanga, pērā i te mate pukupuku, te mate manawa, te mate kohi, me te mate tākihi.

He aha ngā tohu o tēnei mate?

Kāore pea ngā tohu nui o te ascites e puta i te tīmatanga. Nā te mea he iti te nui o te wai e kohia ana i roto i te puku, kāore pea koe e kite. Engari i te piki haere o te nui o te wai e kohia ana, ka kite koe kei te nui haere tō puku, kei te pupuhi hoki. Ka tīmata te piri o ō tarau.

Kei raro nei ētahi tohu hei āwhina i a koe ki te tautuhi mārama i tēnei mate. Tirohia mēnā kei a koe tētahi, ētahi rānei o ēnei.

He aha ngā tino take o te ascites?

E ai ki tā mātou i kōrero ai i mua ake nei, ko te mate ate cirrhosis te tino take. Engari me pēhea tēnei e puta ai?

Whakaarohia tō tātou ate he tātari. Koinei te pūwhakaora toto matua i roto i te tinana. Ko te uaua matua e kawe ana i te toto ki te ate ko te Portal Vein. Ina pakaru te ate i te cirrhosis, ka aukatia te rere o te toto i roto i tēnei uaua. Pērā i te wā e mau ana te paipa wai ki waenganui, kāore e taea e te toto te rere i roto i te ate, ā, ka piki ake te pēhanga.

Ka pā pea tēnei pēhanga nui ki ngā whatukuhu i roto i te wā. Ina kore e taea e ngā whatukuhu te tango tika i te tote tāpiri mai i te tinana, ka tīmata te kohikohi wai ki roto i te tinana. Ka turuturu taua wai tāpiri mai i ngā oko toto ka kohikohi ki roto i te puku.

Ētahi atu take:

• Matepukupuku: Ka taea hoki e ētahi matepukupuku e puta ana i roto i te puku te whakaemi wai i roto i te puku. Ka tukuna e ngā pūtau matepukupuku te wai ki roto i te kōhao puku.
• Te ngoikore o te ngākau: I roto i ētahi āhuatanga ngoikore o te ngākau, kāore e taea e te ngākau te pupuhi i te toto e ranea ana. Kātahi ka whakaputa te tinana i ngā homoni hei pupuri i te wai. Ka taea hoki e tēnei wai te kohikohi ki roto i te puku.

Me pēhea te tautuhi i tēnei mate?

Ina haere koe ki te tākuta, ka tirotirohia koe e ia, ka pātai atu mō ō tohumate. Kātahi ka whakahaerehia pea e ia ētahi whakamātautau hei whakaū i te āhua.

• Paracentesis: Ko te tikanga tēnei ka werohia e te tākuta he ngira tino angiangi ki roto i te puku, ka tangohia he wai iti kua kohia ki reira hei whakamātautau. Ka taea te whakamātautau i tēnei wai hei tirotiro mēnā he mate pāwera, he pūtau matepukupuku rānei.
• Ngā whakamātautau toto: Ka āwhina ēnei ki te whakatau mēnā he mate hauora anō tōu, pērā i te mate huka, he mate pāwera rānei tōu.
• Ngā whakamātautau whakaahua: Ka taea e te hihi-X, te matawai ultrasound, te matawai CT rānei te kite mārama i te āhua o ngā whekau i roto i te puku.
• Whakamātautau SAAG: He whakamātautau motuhake tēnei. Ka whakataurite i ngā taumata o te pūmua e kiia nei ko te albumin i roto i tō toto me te wai i roto i tō puku. Ko te albumin he momo pūmua i hangaia e te ate. Mena he teitei tēnei uara, ko te tikanga kua piki ake te pēhanga i roto i ngā uaua e kawe ana i te toto ki te ate.

He aha ngā maimoatanga mō te ascites?

Ko te maimoatanga e whakawhirinaki ana ki te pūtake o te ascites. Heoi, ko te whāinga whānui ko te whakaiti i te nui o te wai e kohia ana i roto i te puku.

1. Te whakaiti i te konutai: Ko te tote tētahi o ngā tino take o te pupuri wai i roto i te tinana. Mā tō tākuta, mā tō tohunga kai rānei koe e tohutohu kia iti te tote.

• Whakaitihia ngā kai kua tākaihia, ngā kai i hokona mai i te toa, me ngā ranu ki te nui e taea ana.
• Kai atu i ngā huawhenua me ngā hua hou.
• Whakamahia ngā mea kakara (te turmeric, te pepa, te cumin) hei utu mō te tote hei tāpiri i te reka ki te kai.

2. Ngā rongoā whakaheke toto: Ka tohua e tō tākuta ngā rongoā hei āwhina i a koe ki te tango i te wai me te tote nui i roto i tō tinana mā te mimi. Ko ētahi o ngā rongoā e rua e whakamahia whānuitia ana ko te Furosemide (Lasix) me te Spironolactone (Aldactone). Me tango noa ēnei i raro i te tirotiro a te tākuta.

3. Paracentesis: He whakamātautau, he maimoatanga hoki tēnei. Mēnā he nui te wai i roto i te puku, ka werohia he ngira hei tango i te wai hei whakaiti i te pupuhi. Heoi, ka taea e tēnei te whakaemi anō i te wai.

4. Ngā pokanga me ngā mahi pokanga: Ki te kore e taea e ētahi atu maimoatanga te whakahaere i te mate, ka taea e tō tākuta te whakamahi i ēnei kōwhiringa.

• TIPS (Transjugular intrahepatic portosystemic shunt): Ko te whakaurunga o tētahi ngongo mata iti (stent) ki roto i tētahi uaua i roto i te ate hei whakahaere i te rere o te toto.
• Te whakawhitinga ate: Mena kua tata kore e mahi pai te ate nā te cirrhosis, ko te huarahi whakamutunga ko te whakawhitinga o tētahi ate hauora.

Me pēhea te tiaki me te whakahaere i tēnei āhuatanga?

He maha ngā mea ka taea e koe te mahi hei ārai i te puta o te ascites me te whakahaere i tōna kino haere mēnā kei te kitea te mate.

• Kati rawa te inu waipiro:Ko te waipiro te mea matua e kino ai te ate.
• Te whakawhāiti i te tote: Ka kī ngā tākuta kia kaua e neke atu i te 2,000-4,000 mirikaramu tote e kainga ana i ia rā.
• Kia mau tonu te taumaha hauora: He take mōrearea te momona mō te ascites. Mena he ascites tōu, paunatia koe i ia ata, ka tuhia tō taumaha. Mena ka nui ake tō taumaha i te 1 kirokaramu (2.2 pauna) ia rā mō ngā rā e toru karapīpiti, ki te piki ohorere rānei tō taumaha i te 4.5 kirokaramu (10 pauna), me kōrero tonu atu ki tō tākuta.
• Te āhua noho hauora: Kai i te kai taurite, whakakori tinana, me te karo i te momi hikareti.
• Te moe haumaru: Ka pā mai pea ngā mate huaketo pēnei i te Hepatitis B me te C. Ka kino pea te ate i ēnei, ā, ka arahi atu ki te cirrhosis.

Āhea koe me toro atu ki te tākuta?

Mena kei a koe ēnei tohu, rapua tonutia he tohutohu hauora:

• Ki te piki haere tō taumaha
• Mena ka nui haere te puku
• Mena he mamae puku hou, he mamae kino rānei tōu
• Mena he kirika tōu

Mō ngā āhuatanga kino e whai ake nei, haere tonu ki te Tari Whawhati Tata (ETU) o te hōhipera:

• Mena he tino uaua ki te manawa
• Ki te ruaki koe i te toto, i tētahi mea rānei e rite ana ki te paura kawhe

He mate kino te ascites. Ko te tikanga kāore tō ate e mahi tika ana. Nō reira kaua e warewarehia ngā tohu. Mā te maimoatanga tika me ngā huringa momo noho, ka taea e koe te whakahaere i tēnei mate, te ārai i ngā raruraru ka pā mai, me te noho hauora tonu.